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Background  Burgeoning evidence suggests that exercise improves physical and mental health in people with schizophrenia. However, little is known about the feasibility and acceptability of high-intensity training in patients with first-episode psychosis. This qualitative study explored motivation, social interaction and experiences of participants and instructors in relation to an eight-week moderate to high intensity exercise training programme in a clinical trial including patients with first-episode psychosis.    Methods  The study used a combination of method, source and investigator triangulation. Data were collected by means of semi-structured individual interviews with participants at baseline ( n  = 16) and at follow-up ( n  = 9), as well as by means of participant observations during the programme (8 sessions × 1.5 h, 12 h in total) and focus group discussions with participants ( n  = 3) and instructors ( n  = 4), respectively, after the programme. Data were analysed using thematic analysis as described by Braun and Clarke.    Results  Three main themes and ten subthemes emerged during the analysis: 1)  motivation and expectations for enrolment  (subthemes: routines and structure, social obligation, goal setting and self-worth); 2)  new demands and opportunities  (subthemes: practicalities of the training, an understanding exercise setting, and alone and together); and 3)  looking ahead – reflections on impact  (subthemes: restored sleep and circadian rhythm, energy and sense of achievement, changed everyday life, and hope of finding a new path). Findings suggest that the programme was appealing to, and appreciated by, the participants because of its potential to create an equally challenging and caring non-clinical environment.    Conclusions  This study indicates that supervised, group-based, moderate to high intensity exercise training complementary to early intervention in psychosis is acceptable. Specifically, the intervention appeared to provide patients an opportunity to integrate the notion of being a young individual along with being a patient with a psychiatric diagnosis, thus supporting and promoting recovery.    Trial registration   ClinicalTrials.gov  identifier: NCT03409393. Registered January 24, 2018.

bmc psychiatry

The impact of exercise training complementary to early intervention in patients with first-episode psychosis: a qualitative sub-study from a randomized controlled feasibility trial